Theses and Dissertations at Montana State University (MSU)
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Item Mandatory influenza vaccination of staff in long term care and assisted living facilities(Montana State University - Bozeman, College of Nursing, 2020) Kearns, Heidi King; Chairperson, Graduate Committee: Laura LarssonInfluenza vaccination rates of healthcare personnel in long-term care facilities continue to lag behind rates in other healthcare facilities. Long-term care facility residents are at particularly high risk of influenza-related complications and death, and the low vaccination rates of workers in this setting puts residents at even greater risk. Mandatory influenza vaccination policies have been shown to be the most effective means of increasing healthcare personnel influenza vaccination rates. Despite this, long-term care facility staff are the least likely to report working in an environment that requires them to receive influenza vaccination on an annual basis. The purpose of this project was to explore the current policies in place at long-term care and assisted living facilities within Flathead County, Montana, with the hope of continuing to bring awareness to effective means of increasing influenza vaccination rates. This project's secondary goals were to continue cultivating a relationship between the local health department and the facilities and work toward creating sustainability in the annual collection of this data. The results of the surveys conducted showed that facilities with the strongest policy components achieved the highest vaccination rates. Continued support is necessary to assist facilities in strengthening their policies in order to achieve the desired healthcare personnel influenza vaccination rates.Item Grittiness of adolescent residential frontline staff(Montana State University - Bozeman, College of Nursing, 2020) Clark, Jessica Lynn; Chairperson, Graduate Committee: Alice RunningThere are an estimated 48,000 adolescents residing in U.S. residential facilities (Office of Juvenile Justice and Delinquency Prevention [OJJDP], 2019). While this is a 50% reduction in the last two decades (Sickmund, Sladky, Kang, & Puzzanchera, 2017), adolescent residential facilities are housing extremely violent and emotionally disturbed adolescents. Because of the violent nature of these adolescents, turnover rates of staff in this field are as high as 70% (Seti, 2008). There is an abundance of literature assessing burnout, emotional exhaustion, and compassion fatigue in this area but a gap in the literature exists examining individual protective factors, such as grit, of employees who choose to stay despite difficulties associated with the job. Duckworth (2016) describes individuals with high grit as being resilient, tenacious, and having the ability to overcome significant setbacks with high levels of self-control. The aim of this project was to reduce the literature gap and supplement present literature by evaluating grittiness of frontline staff working in an adolescent residential facility as well as determine usefulness of pre-screening future candidates with the use of the Grit Scale. Employees of a Midwest adolescent residential facility who remained in a frontline staff position for greater than one year completed a12-item Grit Scale (Duckworth, 2016) and a demographics questionnaire. Overall, results showed that participants were 'very gritty' with an average grit score of 4.3, falling in the 80th percentile of a large group of adult Americans (Duckworth, 2016). The results of this project are promising and could be used as a foundation for practice change and future research with a larger sample.Item Alarm management on an inpatient surgical unit(Montana State University - Bozeman, College of Nursing, 2016) Whiteley, Rhyana Rose; Chairperson, Graduate Committee: Elizabeth S. KinionAlarm fatigue is a rapidly growing problem in hospitals across the nation, contributing to missed care opportunities and patient safety events. The purpose of the improvement project was to refine the use of audible alarms on an inpatient surgical unit by decreasing the frequency of false and non-actionable alarms, in turn decreasing clinician alarm fatigue and, ultimately, improving patient safety. The biggest culprit of false alarms we found on this type of unit that is of particular concern is the pulse oximetry alarm. Evidence from the literature indicated that capnography was superior to pulse oximetry in the detection of respiratory depression. Although capnography monitoring equipment was available, the current policy on monitoring patients post-operatively at the community hospital in Montana required the use of pulse oximetry and did not include the use of capnography. After determining that there was a gap in practice, an evidence-based practice project was implemented to include the use of capnography for monitoring patients post-operatively. By ensuring that audible alarms are specific to the patient condition, decreasing the frequency of false and non-actionable alarms, alarm fatigue should be lessened. Two policies were put in place that included the use of capnography, one directed at the monitoring of patients using patient-controlled analgesia and one directed at the monitoring of all high-risk patients receiving opioid analgesia. Education of staff regarding the practice change was multi-faceted and included both in-person and online education of the policy changes and both the cognitive and psychomotor aspects on the use of capnography. Additionally, competency validation was assessed in both the cognitive and psychomotor domains. Full assessment of the results of the practice change will take place in 2017.Item Management of work-related low back pain in the primary care setting : a proposal for prevention of disability in rural workers(Montana State University - Bozeman, College of Nursing, 1999) Polich, Christopher Edward; Chairperson, Graduate Committee: Patricia G. Butterfield